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Clinical and Radiological Outcomes of Two Modified Open-Door Laminoplasties Based on a Novel Paraspinal Approach for Treatment of Multilevel Cervical Spondylotic Myelopathy.

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收录情况： ◇ SCIE

作者：

单位： [1]Department of Orthopedic Surgery and Biological Engineering and Regenerative Medicine Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China.

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关键词： axial pain cervical sagittal alignment clinical outcome evaluation deep extensor muscles intermuscular plane muscle atrophy open-door laminoplasty paraspinal approach radiological outcome evaluation semispinalis cervicis

摘要：

a case-control study.to evaluate the outcomes of two modified laminoplasties (LPs) based on a novel paraspinal approach for treating multilevel cervical spondylotic myelopathy.no laminoplasty through a natural intermuscular plane mimicking Wiltse approach to minimize intraoperative injury to extensor muscles has ever been developed and studied.92 patients were enrolled, including patients treated with either modified LP and patients treated with concurrent conventional LP. Operation time, blood loss and complications were recorded. Clinical outcomes were evaluated by VAS, JOA scores and recovery rate. Cervical sagittal alignment was measured on cervical radiographs. Spinal canal expansion was assessed on CT scans. Cross-sectional area (CSA) and atrophy rate (AR) of cervical deep extensors were evaluated on MRI.. the average follow-up duration was 33.05, 31.55, 33.02 and 32.52 months respectively in each group. Compared to concurrent conventional procedure, unilateral muscle-preserving procedure displayed similar while bilateral muscle-preserving procedure showed significantly increased operation time and blood loss, each modified procedure resulted in comparable and satisfied perioperative clinical scores, spinal canal expansion while achieving significantly lower axial pain incidence, better cervical lordosis maintenance and better deep extensor preservation. AR of deep extensors on the open side was significantly lower than that on the hinge side. Bilateral paraspinal approach demonstrated significantly better muscle-preservation on the open side and increased operation duration, with similar clinical scores, axial pain incidence, cervical lordosis maintenance and spinal canal expansion compared to unilateral paraspinal approach. Loss of cervical lordosis was strongly correlated with AR of deep extensors.Paraspinal approach is a good manner to protect deep extensor muscles, the two modified LPs have similar effects on clinical outcomes.Level of Evidence: 3.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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出版当年[2021]版：

大类 | 2 区

医学

小类 | 2 区临床神经病学 2 区骨科

最新[2025]版：

大类 | 2 区医学

小类 | 2 区骨科 3 区临床神经病学

JCR分区：

出版当年[2020]版：

Q1 ORTHOPEDICS Q2 CLINICAL NEUROLOGY

最新[2023]版：

Q1 ORTHOPEDICS Q2 CLINICAL NEUROLOGY

影响因子： 2.7 最新[2023版] 3.3 最新五年平均 3.468 出版当年[2020版] 3.832 出版当年五年平均 2.646 出版前一年[2019版] 3.269 出版后一年[2021版]

第一作者：

第一作者单位： [1]Department of Orthopedic Surgery and Biological Engineering and Regenerative Medicine Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China.

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通讯作者：

通讯机构： [1]Department of Orthopedic Surgery and Biological Engineering and Regenerative Medicine Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China. [*1]Department of Orthopedic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,1095 Jiefang Ave.,Wuhan 430030 China

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Clinical and Radiological Outcomes of Two Modified Open-Door Laminoplasties Based on a Novel Paraspinal Approach for Treatment of Multilevel Cervical Spondylotic Myelopathy.

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